title: Changes in visual acuity and intra-ocular pressure following bleb-related infection: the Japan Glaucoma Society Survey of Bleb-related Infection Report 2.
abstract: OBJECTIVE
  To identify changes in visual acuity and intra-ocular pressure (IOP) 12 months after the development of bleb-related infection.
  
  
  METHODS
  Data obtained from 146 eyes of 146 patients with bleb-related infection were analyzed as a part of the Japan Glaucoma Society Survey of Bleb-related Infection. Multiple logistic regression analysis was conducted to identify factors associated with poor prognosis in visual acuity and increased IOP and for being stage III.
  
  
  RESULTS
  The logMAR increased by a mean of 0.140, 0.440, 1.099 and 1.122 at 12 months postinfection for stage I, II, IIIa and IIIb infections, respectively. The logMAR was significantly worse at 6 and 12 months postinfection in stage IIIb (p = 0.002 and p = 0.003, respectively; Wilcoxon signed-rank test) and at 6 months postinfection in stage IIIa (p = 0.036). The IOP was significantly elevated following infection in both stage IIIa and stage IIIb (p = 0.028 and p = 0.008 at 6 and 12 months, respectively, for stage IIIa; p = 0.002 and p = 0.005 for stage IIIb). The multiple logistic regression analysis revealed that being stage III and positive culture were significant risk factors for poor outcome for visual acuity (Odds ratio: 9.26 and 6.29, respectively) and that being stage III was a prognostic factor for increased IOP (Odds ratio: 8.33). Pseudophakia or aphakia was significantly associated with stage III and stage IIIb infections (Odds ratio: 2.85 and 6.30).
  
  
  CONCLUSIONS
  Stage III bleb-related infection causes significant visual loss and IOP elevation within 12 months after development. Therefore, preventative measures should be taken, especially in cases that are pseudophakic or aphakic.
authors.affiliation: Department of Ophthalmology, Gifu University Graduate School of Medicine, Japan. mmc-gif@umin.net
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Kuwayama
authors.forename: Eiichi
authors.initials: E
authors.lastname: Nomura
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Tanihara
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Mori
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D009877:Endophthalmitis / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D005260:Female; D018463:Filtering Surgery / Q000009:adverse effects*; D005901:Glaucoma / Q000601:surgery*; D006306:Health Surveys; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D007564:Japan; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012955:Societies, Medical; D019738:Surgically-Created Structures; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: bleb-related infection; glaucoma; glaucoma surgery; intra-ocular pressure; trabeculectomy; visual acuity